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https://www.readbyqxmd.com/read/28213607/efficacy-and-safety-of-nonoperative-treatment-for-acute-appendicitis-a-meta-analysis
#1
REVIEW
Roxani Georgiou, Simon Eaton, Michael P Stanton, Agostino Pierro, Nigel J Hall
CONTEXT: Nonoperative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendectomy. OBJECTIVE: To determine safety and efficacy of NOT based on current literature. DATA SOURCES: Three electronic databases. STUDY SELECTION: All articles reporting NOT for AUA in children. DATA EXTRACTION: Two reviewers independently verified study inclusion and extracted data...
February 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/28112705/antibiotics-alone-for-uncomplicated-acute-appendicitis-in-high-operative-risk-adult-patients-analytical-review-of-rcts-and-proposal-of-evidence-based-treatment-decision
#2
Hariscine Keng Abongwa, G Cervellin, A Tarasconi, G Perrone, G Baiocchi, N Portolani, F Catena
BACKGROUND: Clinical trials have so far shown controversial results as regards the standard of care for treating uncomplicated acute appendicitis (uC-AA). High operational risk adult patients (HORAP) could represent selected patients where primary antibiotic conservative therapy (pACT or A) could be indicated. METHODS: We carried a comprehensive search of the PubMed searching engine in the English language scientific literature from 1995 to 2015, using medical subject headings "antibiotics", "uncomplicated appendicitis", "appendicectomy", "conservative treatment", "surgery" and "randomized clinical trial"...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28107859/dengue-fever-may-mislead-the-surgeons-when-it-presents-as-an-acute-abdomen
#3
Bingumal Jayasundara, Lalith Perera, Ajith de Silva
OBJECTIVE: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). METHODS: Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered...
January 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28064301/an-unusual-foreign-body-within-the-appendix
#4
V Lambropoulos, M Fotoulaki, C Kepertis, A Neofytou, I Spyridakis
Ingestion of foreign bodies consist a quite common problem in the pediatric age group. Usually most of them traverse the gastrointestinal tract without complications and only in rare cases they get trapped within the appendix. This case report describes the ingestion of the tip of a mercury thermometer by a six-year-old girl. An elective appendicectomy was performed in order to avoid further complications. To the best of our knowledge, this is the first reported case of the tip of a thermometer within the appendix...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28054237/what-is-the-future-for-general-surgery-in-model-3-hospitals
#5
K Mealy, F Keane, P Kelly, G Kelliher
BACKGROUND: General Surgery consultant recruitment poses considerable challenges in Model 3 Hospitals in Ireland. AIM: The aim of this paper is to examine General Surgery activity and consultant staffing in order to inform future manpower and service planning. METHODS: General surgical activity in Model 3 Hospitals was examined using the validated 2014 Hospital Inpatient Enquiry (HIPE) dataset. Current consultant staffing was ascertained from hospital personnel departments and all trainees on the National Surgical Training Programme were asked to complete a questionnaire on their career intentions...
January 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28003294/acute-uncomplicated-appendicitis-study-rationale-and-protocol-for-a-multicentre-prospective-randomised-controlled-non-inferiority-study-to-evaluate-the-safety-and-effectiveness-of-non-operative-management-in-children-with-acute-uncomplicated-appendicitis
#6
Jane Xu, Yingrui Cyril Liu, Susan Adams, Jonathan Karpelowsky
INTRODUCTION: This article presents an overview of a prospective randomised controlled non-inferiority study designed to evaluate the safety and effectiveness of non-operative management (NOM) with operative management in children with acute uncomplicated appendicitis (AUA). Here, we present the study protocol for this APRES study, a multicentre Australian study. The rationale and details of future analysis, in particular, non-inferiority calculations, cost-effectiveness, feasibility and acceptability of each intervention...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27938532/a-rare-case-of-perforation-of-the-subhepatic-appendix-by-a-toothpick-in-a-patient-with-intestinal-malrotation-laparoscopic-approach
#7
V Grassi, J Desiderio, A Cacurri, A Gemini, C Renzi, Alessandro Corsi, I Barillaro, A Parisi
Foreign body ingestion is not an uncommon problem in clinical practice. While most ingested foreign bodies pass uneventfully through the gastrointestinal tract, sharp foreign bodies such as toothpicks should cause intestinal perforation. We reported the case of a perforation of the appendix caused by a toothpick, which also pierced the liver without hepatic damages, in a male with an intestinal malrotation and subhepatic appendix. The patient was admitted to our hospital for abdominal pain in the right upper quadrant...
July 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/27872936/clinics-in-diagnostic-imaging-171-caecal-volvulus-with-underlying-intestinal-malrotation
#8
Su Kai Gideon Ooi, Tien Jin Tan, James Chi Yong Ngu
A 46-year-old Chinese woman with a history of cholecystectomy and appendicectomy presented to the emergency department with symptoms of intestinal obstruction. Physical examination revealed central abdominal tenderness but no clinical features of peritonism. Plain radiography of the abdomen revealed a grossly distended large bowel loop with the long axis extending from the right lower abdomen toward the epigastrium, and an intraluminal air-fluid level. These findings were suspicious for an acute caecal volvulus, which was confirmed on subsequent contrast-enhanced computed tomography (CT) of the abdomen and pelvis...
November 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27857807/transanal-protrusion-of-ventriculoperitoneal-shunt-via-appendicular-perforation-a-rare-case-report
#9
Shaam Bodeliwala, Atul Agrawal, Amit Mittal, Daljit Singh, B G Vageesh, Hukum Singh
Perforation of abdominal viscera and protrusion of the distal end of ventriculoperitoneal shunt (VPS) through natural orifice is well known but rare complication. We report a case of a transanal protrusion of distal end of VPS through appendix perforation without any symptomatology of prior appendicitis. To the best of our knowledge, no case of such kind has been reported in literature yet. The management plan of these patients should be looked in a different way because they may have underlying inflammation of the appendix and distal end of shunt removal should be done by proper surgical exploration followed by added appendicectomy...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27806437/dilemma-of-mucosal-appendicitis-a-clinico-pathological-entity-a-retrospective-cohort-study
#10
Ryo Mizumoto, Adam T Cristaudo, Nai Kid Lai, Gamini Premaratne, Rasika Hendahewa
BACKGROUND: The presence of mucosal inflammation within appendicectomy specimens is poorly described in the literature, and there is debate regarding the clinical significance of this histological finding. The aim of this study is to correlate clinical and radiological data with histologically confirmed acute mucosal appendicitis (MA). METHODS: A retrospective cohort study was performed to identify all patients who underwent appendicectomy over 5 years at Caboolture Hospital...
November 2, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27800658/interhospital-transfer-delays-emergency-abdominal-surgery-and-prolongs-stay
#11
Alexandra M Limmer, Michael B Edye
BACKGROUND: Interhospital transfer of patients requiring emergency surgery is common practice. It has the potential to delay surgical intervention, increase rate of complications and thus length of hospital stay. METHODS: A retrospective cohort study was conducted of adult patients who underwent emergency surgery for abdominal pain at a large metropolitan hospital in New South Wales (Hospital A) in 2013. The impact of interhospital transfer on time to surgical intervention, post-operative length of stay and overall length of stay was assessed...
November 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27789546/stump-appendicitis-5%C3%A2-years-after-laparoscopic-appendicectomy
#12
Andrew Phillip Maurice, Hany Ibrahim, Robert Franz, Harish Iswariah
A 31-year-old healthy man presented with right lower quadrant pain and tenderness, mild neutrophilia and clinical presentation consistent with appendicitis, despite undergoing a laparoscopic appendicectomy 5 years prior. CT scan demonstrated a caecal phlegmon, in the expected region of the appendiceal stump. The patient was taken for laparoscopy and a 2 cm inflamed appendiceal stump was encountered. A distal caecectomy was performed and the patient made an unremarkable recovery. Histological examination was consistent with acute inflammation of the appendiceal stump...
October 27, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27785329/no-need-of-fascia-closure-to-reduce-trocar-site-hernia-rate-in-laparoscopic-surgery-a-prospective-study-of-200-non-obese-patients
#13
Rikki Singal, Muzzafar Zaman, Amit Mittal, Samita Singal, Karamjot Sandhu, Anshu Mittal
BACKGROUND: Laparoscopy is widely practiced and offers realistic benefits over conventional surgery. Port closure is important after a laparoscopic procedure to prevent port site incisional hernia. Larger port size and increasing numbers of ports needed to perform more complex laparoscopic procedures are likely to increase the incidence of port site hernias (PSHs). PSHs tend to develop more frequently at umbilical and midline port sites due to the thinness of the umbilical skin and weaknesses in the linea alba...
October 2016: Gastroenterology Research
https://www.readbyqxmd.com/read/27775294/-fast-track-protocol-for-children-undergoing-appendicectomy
#14
M Fanjul, L Pérez, J Cerdá, M Zornoza, R Rojo, I Simal, M A García-Casillas, C Corona, D Peláez, E Molina, A Parente, S Rivas, J M Angulo, E De Tomás
BACKGROUND: Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates. METHODS: Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis...
October 10, 2015: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27686264/single-incision-laparoscopic-appendicectomy-versus-conventional-three-port-laparoscopic-appendicectomy-a-systematic-review-and-meta-analysis
#15
REVIEW
Omar E Aly, Douglas H Black, Haroon Rehman, Irfan Ahmed
BACKGROUND: Appendicectomy is a well-established surgical procedure used in the management of acute appendicitis. The operation can be performed with minimally invasive surgery or as an open procedure. A further development in the minimally invasive appendicectomy technique has been the introduction of single incision laparoscopic surgery (SILA). AIM: To ascertain any differences in outcomes from available trials comparing SILA with conventional multi-incision laparoscopic appendicectomy (CLA)...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27670963/benchmarking-the-value-of-ultrasound-for-acute-appendicitis-in-children
#16
Thomas P Cundy, Roger Gent, Claire Frauenfelder, Laura Lukic, Rebecca J Linke, Day Way Goh
BACKGROUND: This study appraises the diagnostic quality of ultrasound for acute appendicitis in children and consequently challenges the perception of inferior accuracy and suitability compared to computed tomography (CT). METHODS: Radiologist reports for consecutive "query appendicitis" ultrasound studies were retrieved from a hospital database for the study period 2009-2014. Children who subsequently underwent appendicectomy were identified. Corresponding operative and histopathology findings were evaluated...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27662216/acute-appendiceal-abscess-and-atraumatic-splenic-rupture-a-case-of-dual-pathology
#17
Piriyankan Ananthavarathan, Kamlesh Patel, Catherine Doran, Nigel Suggett
INTRODUCTION: Atraumatic splenic rupture is a rare surgical emergency that is often attributed to neoplastic or infectious causes. Rarely, it has been identified to also occur in the setting of an acute severe sepsis and in cases of pelvic or splenic abscess formation post-appendicectomy. However, to our knowledge, the co-presentation of acute appendiceal abscess and splenic rupture has not been previously described. PRESENTATION OF CASE: We present the case of a 67-year old male with decompensating haemorrhagic shock secondary to atraumatic splenic rupture on a background of an inadequately treated complicated appendicitis originally managed as diverticulitis with antibiotics in the community...
April 13, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27662036/primary-mucinous-carcinoma-of-the-fallopian-tube-case-report-and-review-of-literature
#18
Abigail Wheal, Robert Jenkins, Yoshiki Mikami, Nagindra Das, Lynn Hirschowitz
Primary mucinous carcinoma of the fallopian tube is extremely rare. We report the detailed characterization of a mucinous carcinoma arising in the fimbrial end of the fallopian tube in a 74-yr-old woman. The patient presented with recurrent urinary tract infection and urinary tract obstruction secondary to a large right ovarian mass. She had an appendicectomy as an 11 yr old. Serum CA-125 was raised at 239 U/mL. Computed tomographic scans showed bilateral, cystic ovarian tumors but no other intra-abdominal abnormality...
September 22, 2016: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/27658707/amyand-s-hernia-with-appendicitis-masquerading-as-fournier-s-gangrene-a-case-report-and-review-of-the-literature
#19
Kishore Rajaguru, Daniel Tan Ee Lee
BACKGROUND: The incarceration of an appendix within an inguinal hernia sac is known as Amyand's hernia. Appendicitis in Amyand's hernia accounts for 0.1 % of the cases. An aggressive necrotizing infection of the genitalia and perineum, called Fournier's gangrene, can rapidly progress to sepsis and death. We describe a rare case of Fournier's gangrene complicating Amyand's inguinal hernia which has rarely been reported in the literature. CASE PRESENTATION: This case report describes the presentation and management of a 47-year-old Chinese man who presented with pus discharge from his right inguinoscrotal region and lower abdominal pain with clinical signs of Fournier's gangrene...
September 22, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27638629/magnitude-of-non-operative-surgical-emergency-admissions-service-implications-for-surgical-and-radiological-practice
#20
R M Heaney, I Reynolds, R S Ryan, I Khan, W Khan, R Waldron, K Barry
BACKGROUND: Financial sustainability is an area of sharp ongoing focus across the broad spectrum of the Irish Health Service. Recent attention has been drawn to the financial implications of non-operative surgical admissions, suggesting that some of these may be unnecessary. AIMS: In this study, we aim to determine the volume of emergency surgical admissions to Mayo University Hospital (MUH), in particular, to identify the scale of non-operative admissions and to assess the wider inherent implications for acute hospital services...
September 8, 2016: Irish Journal of Medical Science
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